Provider Demographics
NPI:1003410762
Name:HILL, STEPHEN DAVID (PHARM D)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:DAVID
Last Name:HILL
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEACHVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72438-9097
Mailing Address - Country:US
Mailing Address - Phone:870-539-6831
Mailing Address - Fax:870-539-6681
Practice Address - Street 1:109 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LEACHVILLE
Practice Address - State:AR
Practice Address - Zip Code:72438-9097
Practice Address - Country:US
Practice Address - Phone:870-539-6831
Practice Address - Fax:870-539-6681
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD12798183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist